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20 July 2012

In session with a client yesterday, I did something intuitively that I have never tried before. This client is very much a visual learner. He/she has engaged in some creative therapies that have really drawn out their emotions, something that has been very difficult for them to do.

This client's childhood had some extreme difficulties and their coping mechanism seems to have been to play down the experience and distance themselves from it. I have a lot of respect for people's coping mechanisms. They do what they do with what they've got, and for a young child with a cruel parent, there isn't anything to do BUT distance themselves from it and protect themselves from continual emotional (and physical) batterings. So it's no surprise that in adulthood this person will continue to downplay the impact and significance of their experience.

Nothing wrong with that, I would say, unless this state of being is interfering in the here and now. What if they are so separated from the painful experience, that they have no conscious awareness that they are drawn to relationships in adulthood that reenact the earlier pain? Well, after several sessions, this client could see that this was the case. Not just intimate relationships but other relationships with friends and colleagues. But how to unpick this and help this client to let go of this subconscious drive to repeat old pain? I had some ideas and interpretations, but these are not really of any use - the client has to learn their truth for themselves. I am there to help them find their truth, not my version of it.

So this client, who was very adept at not feeling the feelings that go with a sedimented belief that he/she was essentially not okay. So adept in fact that he/she could not remember what the feelings were when they were, for example, being hit for nothing. So I came up with various ways that we could access the feelings to enable him/her to process the pain and hopefully, move on.

The first thing I did was to ask them to imagine they were a movie director and that they were telling a young child actor what they should be doing in order to play their part (of the client as a child) accurately, and tell the adult female actor to do what the mother did to them when they were young. The simple act of making it third person enabled the client to talk much freely of their childhood experience, although there was no emotional component to this narrative, it was a good start.

The next intervention was to suggest sandplay therapy. This proved to be very catalytic. They chose items at random but the sculpture that emerged ended up being a visual representation of the family dynamics and the client's current position of hiding themselves. The client then made changes to the sculpture to represent how they would like to be in relation to their family members, and to the things important to them. They were very surprised at how powerful this experience was.

I also got the client to do a couple of visualisations. One was to meet their self-saboteur and this was a useful exercise. We now use the symbology that appeared to the client in our work, trying to get the shift that they are after.

Last week I used some Transactional Analysis, which is very rare for me. But it seemed like a useful offering to get the client to see their current life stance. There are 4 life positions, according to TA; I'm okay/You're okay (the ideal one), I'm okay/You're not okay, I'm not okay/You're not okay (pretty dire one to have) and I'm not okay/You're okay. I drew four boxes and wrote each position in and my client immediately identified with I'm not okay/You're okay which was what I expected.

This week, we contracted to investigate this further. As soon as we started talking about his/her perceived 'not okay-ness" I realised that it may be useful for this client to have a visual representation of what he/she was telling me. So I asked his/her permission, then had a piece of paper and pen and wrote down what he/she was saying, in a sort of spider diagram. We looked at his/her reasons for believing his/her "not okay-ness", then we looked at "the stuff in the way" - this is how we have been describing what is in the way of him/her being and doing what they really want in life. We explored what that consisted of and it's old relationships, childhood stuff. I asked for the feelings that went with that "stuff" (at this stage I usually have a list of emotion words for those that struggle to name them - as many clients do), then I asked for a list of feelings that went with the not-okay-ness. Then we explored what happens at those times that he/she does feel okay - the thoughts that go with that and then the feelings.

By the end of this I had a piece of A4 with different sections, with the thoughts and feelings listed separately and little arrows with offshoots to show associated thoughts. I handed it to my client and they very carefully looked at my "session map". They volunteered that this was incredibly powerful for them, that there was something more real about seeing it written down. When we talk in the session the words make sense but they don't always stick around. Seeing them written down makes it more real, more penetrative somehow.

As a visual learner myself, I can see how this could be a huge help to somebody's process. Something that Yalom said to me about my childhood really stuck with me - it released me from a vice-like grip that dates back to minus-my existence (or so it seems). They were very simple words, which I did not hear at the time. When I listened to the recording of the session afterwards, I heard it, but it didn't sink in, It was in transcribing the session, and reading Yalom's words in black and white, that the healing took place.

I shall develop this "session mapping" further.

Amanda Williamson is a professional, private counsellor working in central Exeter, Devon.

13 July 2012

Lately I have been embroiled in an incredibly difficult ethical dilemma, the nature of which I am not currently at liberty to reveal. Unfortunately there are a few therapists out there that risk tarnishing the profession and may cause clients harm.

One of the BACP's roles is to protect clients. I would not consider being a counsellor without being part of a professional body.

The point of this blogpost is to urge those seeking a counsellor or psychotherapist, or those helping others find a counsellor or psychotherapist, to make sure that the person they choose to go with, or the organisation they seek counselling with is a member of the BACP or the UKCP (a similar organisation with similar aims). Without this, in the event of a complaint there is no recourse or accountability. Seeing a member of either the BACP or UKCP offers some protection, as if you feel that your counsellor/psychotherapist has acted unethically towards you then there is a complaints procedure whereby you can make an official complaint and it will be investigated. If there is a serious breach of ethics then the practitioner may be struck off the register.

The sad thing is, anybody can set up to become a counsellor without insurance or membership of a regulatory organisation. Hopefully, government policy will change on this, because as it stands, there is nothing to stop unethical practitioners from abusing vulnerable clients or acting unethically.

Amanda Williamson is a professional counsellor working privately in Exeter, Devon.